Alternatives to the Glasgow Coma Scale as a quality of life predictor following traumatic brain injury

Conventional "staging " of traumatic brain injury (TBI) typically uses depth of coma assessed by the Glasgow Coma Scale (GCS) score near admission as a severity marker. Frequently, early GCS scores are contaminated by alcohol or drug ingestion and other, nonneurological organ system trauma. As well, this measure's usefulness is limited due to its restricted range in survivors. Here we explore the utility of using length of posttraumatic amnesia, coma duration, and age as indirect markers of severity. Cluster analytic techniques were used to examine the relationship of severity so defined to long-term outcome in 106 mild, moderate, and severe TBI patients. Results indicate complex relationships between cluster groups with the influence of age of patient being highlighted as an important moderator in determining severity of injury and later psychosocial outcome.